一家儿科大学医院中引起发热性尿路感染的尿路病原体的菌血症和抗菌药耐药性模式。

IF 1.7 Q3 INFECTIOUS DISEASES
GERMS Pub Date : 2023-09-30 eCollection Date: 2023-09-01 DOI:10.18683/germs.2023.1387
Hassan Heshmat, Marwa Meheissen, Ahmed Farid, Eman Hamza
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引用次数: 0

摘要

导言:儿童发热性尿路感染(UTI)是最严重的细菌感染之一。治疗不当会导致肾脏结疤和永久性肾损伤。UTI患儿中有8%至10%可能同时患有菌血症。本研究旨在估算尿毒症相关菌血症的发病率,并确定引起尿毒症的常见微生物及其抗菌药敏感性模式,以帮助指导经验性抗菌治疗:本研究对亚历山大大学儿童医院收治的发热性 UTI 儿童进行了为期 6 个月的研究。收集血液和尿液样本进行培养和抗菌药敏感性检测:研究共纳入 103 名儿童,中位年龄为 12 个月(IQR 6.0-24.0)。63.1%的患儿(n=65)伴有菌血症。与非菌血症组相比,菌血症组的体温中位数为 38.40°C(IQR 38.15-38.60),肌酐中位数为 0.18 mg/dL(IQR 0.14-0.25),均显著高于非菌血症组(分别为 p=0.005 和 p=0.034)。大肠杆菌(n=51;49.5%)和肺炎克雷伯菌(n=30;29.1%)是最常见的分离菌。大多数分离菌(n=68;66%)对多种药物具有耐药性(MDR),其次是广泛耐药菌(XDR)(n=16;15.5%)和泛耐药菌(PDR)(n=1;1%)。大肠杆菌对庆大霉素和头孢曲松的耐药性较低(分别为9.8%和13.7%):结论:大肠杆菌仍是最重要的UTI病原体。结论:大肠埃希菌仍是最重要的UTI病原体,头孢曲松和庆大霉素是我院治疗发热性UTI的最佳经验选择。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Bacteremia and antimicrobial resistance pattern of uropathogens causing febrile urinary tract infection in a Pediatric University Hospital.

Introduction: Febrile urinary tract infections (UTIs) in children are among the most serious bacterial infections. Inadequate treatment can lead to kidney scarring and permanent kidney damage. Eight to ten percent of children with UTIs could have concomitant bacteremia. The study aimed to estimate the prevalence of UTI-associated bacteremia and identify common organisms causing UTIs and their antimicrobial susceptibility patterns to help guide empiric antimicrobial therapy.

Methods: The current study was conducted over a 6-month period on children admitted with febrile UTIs at Alexandria University Children's Hospital. Blood and urine samples were collected for culture and antimicrobial susceptibility.

Results: A total of 103 children with a median age of 12 months (IQR 6.0-24.0) were included in the study. Concomitant bacteremia was present in 63.1% (n=65). The median temperature of 38.40°C (IQR 38.15-38.60) and the median creatinine level of 0.18 mg/dL (IQR 0.14-0.25) were significantly higher in the bacteremic group compared to the non-bacteremic group (p=0.005, p=0.034, respectively). E. coli (n=51; 49.5%) and Klebsiella pneumoniae (n=30; 29.1%) were the most common isolated organisms. Most (n=68; 66%) of the isolated organisms were multidrug-resistant (MDR), followed by extensively drug-resistant (XDR) (n=16; 15.5%), and pan-drug-resistant (PDR) organisms (n=1; 1%). E. coli showed lower resistance to gentamicin and ceftriaxone (9.8 % and 13.7%, respectively).

Conclusions: E. coli remains the most important UTI pathogen. Ceftriaxone and gentamicin are good empiric options for febrile UTIs in our hospital.

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GERMS
GERMS INFECTIOUS DISEASES-
CiteScore
2.80
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